Fermented Wheat Germ Extract
Also known by these names
- Brand names include Avemar, Avé, AvéULTRA, AWGE, Metatrol and OncoMAR
- FWGE
- MSC
- Wheat germ extract
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Key Points
- Fermented wheat germ extract (FWGE) is a dietary supplement.
- BCCT interest in FWGE derives from its anticancer and anti-metastatic effects across several types of cancer.
- FWGE has enhanced the effectiveness of tamoxifen treatments in estrogen receptor-positive breast cancer cells.
- FWGE has reduced some chemotherapy-related side effects.
- Side effects and adverse events are uncommon and usually mild. Some patients should not use FWGE.
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Fermented wheat germ extract (FWGE) is a dietary supplement sold as brand names including Avemar, Avé, AvéULTRA, AWGE, Metatrol and OncoMAR.
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Clinical Evidence
- Improved progression-free and overall survival in high-risk melanoma patients when added to treatment with dacarbazine in a pilot study
- Improved progression-free and overall survival in people with colorectal cancer treated with radical surgery plus radiotherapy and/or chemotherapy
- Improved immunity in pediatric patients undergoing chemotherapy
Lab and Animal Evidence
Read more
- A 2012 review concluded that FWGE has these properties in laboratory cell and animal testing:
- Promotes cell death (apoptosis) of cancer cells while leaving normal cells unharmed
- Starves the sugar supply required by cancer cells to survive
- Unmasks cancer cells so they can be more readily targeted by the immune system
- Prevents abnormal cells from repairing themselves
- A 2004 study found that FWGE interacted with tamoxifen treatment, enhancing the efficacy of tamoxifen, an ER antagonist, in inducing cell death (apoptosis) in ER+ breast cancer cells. FWGE also enhanced estrogen-receptor (ER) activity alone, with further decreased ER activity when used with tamoxifen beyond tamoxifen's effect in cells.
- FWGE induced cell death (apoptosis), showed antiproliferative effects against human ovarian cancer cell lines and enhanced cytotoxicity of cisplatin and docetaxel.
A 2018 review found that FWGE has shown anticancer and anti-metastatic effects in cell studies with these further cancers:
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
Clinical Evidence
In all, evidence to date is positive but not rigorous for improvements in side effects and quality of life:
- Improved quality of life with lung cancer patients receiving chemotherapy and/or radiotherapy in a small study and with people with non-small cell lung cancer receiving chemotherapy
- Improved physical functions, emotional functions, global state of health, nausea and vomiting, insomnia and constipation in breast cancer patients in a small study
- Improved quality of life in head and neck cancer patients when added to standard therapy
- Reduced chemotherapy-induced fever that accompanies an abnormally low number of neutrophil granulocytes (a type of white blood cell) in the blood in pediatric cancer patients and fewer immune compromised/neutropenic episodes in pediatric patients undergoing chemotherapy
Cautions
FWGE is not recommended for use by pregnant and nursing women, patients with sensitivity to gluten, those with fructose intolerance, or patients with organ or tissue transplants.
Because FWGE may have estrogen-receptor activity, if you have an estrogen-dependent cancer (some breast, ovarian or uterine cancer) and are thinking about taking FWGE, consult with a licensed provider who is knowledgeable and experienced with using this supplement in cancer.
Access
Fermented wheat germ extract supplements are widely available.
Dosing
BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated. Levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.
Dosage recommendations are available from these sources:
Integrative Programs, Protocols and Medical Systems
- Programs and protocols
- Alschuler & Gazella complementary approaches:
- Block program
- Targeted therapy when other treatment isn't working
Non-cancer Uses of FWGE
FWGE has been used in treatment for heart disease as well as systemic lupus erythematosus (SLE), an autoimmune disease. BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.
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Written by Nancy Hepp, MS, with review by Laura Pole, RN, MSN, OCNS; most recent update on August 14, 2019.
- Demidov LV, Manziuk LV, Kharkevitch GY, Pirogova NA, Artamonova EV. Adjuvant fermented wheat germ extract (Avemar) nutraceutical improves survival of high-risk skin melanoma patients: a randomized, pilot, phase II clinical study with a 7-year follow-up. Cancer Biotherapy & Radiopharmaceuticals. 2008 Aug;23(4):477-82.
- Jakab F, Shoenfeld Y et al. A medical nutriment has supportive value in the treatment of colorectal cancer. British Journal of Cancer. 2003 Aug 4;89(3):465-9.
- Radossi AL, Taromina K et al. A systematic review of integrative clinical trials for supportive care in pediatric oncology: a report from the International Society of Pediatric Oncology, T&CM collaborative. Supportive Care in Cancer. 2018 Feb;26(2):375-391.
- Yeend T, Robinson K, Lockwood C, McArthur A. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: a systematic review. JBI Library of Systematic Reviews. 2012;10(42 Suppl):1-12.
- Marcsek Z, Kocsis Z, Jakab M, Szende B, Tompa A. The efficacy of tamoxifen in estrogen receptor-positive breast cancer cells is enhanced by a medical nutriment. Cancer Biother Radiopharm. 2004 Dec;19(6):746-53.
- Judson PL, Al Sawah E et al. Characterizing the efficacy of fermented wheat germ extract against ovarian cancer and defining the genomic basis of its activity. International Journal of Gynecological Cancer. 2012 Jul;22(6):960-7; Wang CW, Wang CK et al. Preclinical evaluation on the tumor suppression efficiency and combination drug effects of fermented wheat germ extract in human ovarian carcinoma cells. Evidence-based Complementary and Alternative Medicine. 2015;2015:570785.
- Zhurakivska K, Troiano G et al. The effects of adjuvant fermented wheat germ extract on cancer cell lines: a systematic review. Nutrients. 2018 Oct 19;10(10). pii: E1546.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Hidvegi M, Moldvay J, Lapis K. Fermented wheat germ extract improves quality of life in lung cancer patients. (In Hungarian.) (Medicus Anonymus/Pulmono 11: 13-14). 2003. As described at CAM-Cancer. Fermented wheat germ extract. February 8, 2017. Viewed January 1, 2017.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Sukkar SG, Cella F et al. A multicentric prospective open trial on the quality of life and oxidative stress in patients affected by advanced head and neck cancer treated with a new benzoquinone-rich product derived from fermented wheat germ (Avemar). Mediterranean Journal of Nutrition and Metabolism. 2008;1:37–42.
- Garami M, Schuler D et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. Journal of Pediatric Hematology/Oncology. 2004 Oct;26(10):631-5.
- Radossi AL, Taromina K et al. A systematic review of integrative clinical trials for supportive care in pediatric oncology: a report from the International Society of Pediatric Oncology, T&CM collaborative. Supportive Care in Cancer. 2018 Feb;26(2):375-391.
- Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
- Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Treatment. New York: Bantam Dell. 2009.
View All References
More Information
- Memorial Sloan Kettering Cancer Center’s About Herbs: Wheat germ extract
- CAM-Cancer Summaries: Fermented wheat germ extract
- Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
- TRC Natural Medicines: Fermented Wheat Germ Extract (subscription required): in-depth information, ratings of effectiveness and safety and evaluation of specific resveratrol products
- Susan G. Komen: Fermented wheat germ extract
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
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